Diabulimia: The Illusion of Control

I was diagnosed with type 1 diabetes at the age of 14. Suddenly, I went from being a carefree teenager to a patient who had to be concerned with every carbohydrate in a cracker. Not only was I dealing with the hormones and emotional adjustments of adolescence, but I was also learning to cope with and accept a disease that wanted a part of every minute of my day. I also had to deal with the illusion that other teenagers had nothing to worry about except how to fit in, and the fact that I was no longer part of that group of carefree kids. I was now the student who had a free pass from teachers to eat or drink during class. The girl who left fourth period ten minutes early to go to the nurse’s office to test her glucose. The sick kid who had a doctor’s appointment every two months and came late to school because of it.

By the age of 16, I was very anxious to be considered “normal.” Over the two years since my diagnosis, I had lost many fickle “friends” who used the excuse that they could catch diabetes by sitting next to me. I knew that it was really the fact that teenagers are so unforgiving of nuances that by sitting next to me during lunch or admitting that I was their friend, they were adding another difference between them and the “accepted.”

I had gained about 15 much-needed pounds in those two years, having had only 110 pounds on my 5’8″ frame at diagnosis. I was jaded by questions from relatives who seemed to only want to discuss “Katherine with diabetes” and not any other part of my life. I was tired of the doctors telling me what I could and could not eat, what time I needed to eat, in what range my blood sugars needed to be, and how many minutes of exercise I needed. I was exhausted by all the thinking, the waking up at 6:00 AM to test my glucose and inject NPH, and all the bruises across my stomach and thighs from needles. I was angry that I couldn’t just be a normal teenage girl and that my years of adolescent discovery were being tarnished by an all-consuming disease.

To silently buck the system, I started to skip meals. I lied to my doctors about the meals I didn’t eat and the insulin I didn’t inject. When my mother noticed that I had skipped dinner for weeks, claiming to be sick or saddled with too much homework, she became concerned. To satisfy her and stop the questions, I began to eat again. But then I would go to the bathroom, stick the back of a spoon down my throat, and throw it all up. After a few months of doing this, I no longer needed to use a spoon or a finger because my gag reflex was so highly developed.

I kept this up for over a year. I got back down to 110 pounds and learned to love the feeling of an empty, churning stomach. The knowledge that I had a secret that I didn’t share with anyone helped me feel secure. I didn’t do these things to get skinny. I did them to feel like I had control over some portion of my life, no matter how small a part or how destructive the path.

The doctors struggled to understand my waning control of my glucose, but attributed it to teenage hormone changes. My parents wondered why I was losing so much weight, but figured that I was hitting a teenage growth spurt. I felt guilty for lying to everyone, but was comforted knowing that even though I had to tell these people about every shred of food I ate while they calculated my pee, weighed me, and took blood from me over and over again, I still had something about me that was personal and private.

I am not proud of this period of my life. I’m not sure that I’ve even ever admitted most of it to my parents to this day. But I feel that it is important to be honest because I know that there are many adolescents with diabetes who have done and will do the same thing. Going through teenage years is tough enough, but add a chronic disease to it and you’re likely to run into some emotional issues. I don’t purge or starve myself these days. I’m actually a pretty stellar cook. It was simply a coping method that I used to deal with accepting a disease as a permanent part of my life. There are surely better coping methods available, but this is the path that I took.

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